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Hsu HJ, Chen YS, Chen PH, Chen HS, Chen CM. The correlation between surgical reference points: antilingula, lingula, and mandibular foramen. J Stomatol Oral Maxillofac Surg 2020; 122:535-538. [PMID: 33307209 DOI: 10.1016/j.jormas.2020.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/21/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022]
Abstract
The purpose of the present study was to investigate and determine the anatomical relationship between the antilingula, lingula, and mandibular foramen using cone-beam computed tomography (CBCT). METHODS CBCT images of 90 participants (180 mandibular ramus) were collected. The locations of and distances between the antilingula, lingual, and mandibular foramen according to side (right and left) and skeletal patterns were measured and then evaluated by statistical analysis. RESULTS Only 27 participants (15%) had bilateral distinct antilingula, lingula, and mandibular foramen. The antilingula was located anteriorly (4.28 mm and 3.59 mm) and above (1.99 mm and 8.52 mm) the lingula and mandibular foramen. The lingula was behind (0.69 mm) and above (6.53 mm) the mandibular foramen. Skeletal Class III was anterior and inferior to Class II and Class I in the antilingula, lingula, and mandibular foramen. Considering the correlations of landmarks, we found that the lingula was strongly correlated with the mandibular foramen on the X axis (r = 0.757) and Y-axis (r = 0.878). CONCLUSION The antilingula is located anteriorly and above the lingula and mandibular foramen. The lingula is behind and above the mandibular foramen. The osteotomy line of orthognathic surgery can only be safely designed through actual measurement of the locations of the antilingula, lingula, and mandibular foramen.
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Affiliation(s)
- Han-Jen Hsu
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Sheng Chen
- Dental Department, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
| | - Ping-Ho Chen
- School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Han-Sheng Chen
- Dental Department, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
| | - Chun-Ming Chen
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Hsiao SY, Hsu KJ, Liang SW, Tseng YC, Chen CM. The presence probability of mandibular lingla and antilingula. J Stomatol Oral Maxillofac Surg 2020; 121:621-625. [PMID: 32222578 DOI: 10.1016/j.jormas.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The lingula and antilingula are crucial surgical landmarks for mandibular setback surgery. The purpose of study was to investigate the correlation of presence probability between lingual and antilingula. MATERIALS AND METHODS A total of 180 cone-beam computed tomography sides were collected from 90 patients. The probability of absence of the lingula and antilingula was recorded with respect to the gender, mandible (unilateral and bilateral), and skeletal patterns (Class I, II, III); in addition, the correlations between these variables were analysed. RESULTS Of the 180 sides, 9 sides showed the absence of the lingula (5%) and 34 sides showed the absence of the antilingula (18.9%). Pearson's test revealed that the presence of the lingula and antilingula differed nonsignificantly with respect to gender and skeletal patterns, respectively. The bilateral presence of the lingula was observed in 16 sides (91.1%), and that of the antilingula was observed in 122 sides (67.8%). Pearson's test verified a significant correlation between the presence of the left and right lingula (P<0.05). By contrast, gender and skeletal patterns were nonsignificantly correlated with the presence of the lingula and antilingula. The presence of the lingula was also nonsignificantly correlated with that of the antilingula. CONCLUSION Gender and skeletal patterns were nonsignificantly correlated with the presence of the lingula and antilingula, respectively. The presence of the lingula was also nonsignificantly correlated with that of the antilingula. Consequently, lingula and antilingula cannot serve as the absolute standards for mandibular setback surgery.
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Affiliation(s)
- S-Y Hsiao
- Department of dentistry for child and special needs, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - K-J Hsu
- Graduate institute of dental sciences, College of dental medicine, Kaohsiung medical university, Kaohsiung, Taiwan; Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - S-W Liang
- Graduate institute of dental sciences, College of dental medicine, Kaohsiung medical university, Kaohsiung, Taiwan
| | - Y-C Tseng
- Graduate institute of dental sciences, College of dental medicine, Kaohsiung medical university, Kaohsiung, Taiwan; Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - C-M Chen
- Graduate institute of dental sciences, College of dental medicine, Kaohsiung medical university, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Miura K, Yamaoka S, Arizono K, Ohba S, Koga T, Kawasaki T, Yoshida N, Asahina I. Long-term skeletal stability in the treatment of mandibular prognathism with a physiological positioning strategy. Br J Oral Maxillofac Surg 2019; 57:529-35. [PMID: 31078333 DOI: 10.1016/j.bjoms.2019.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/21/2019] [Indexed: 11/21/2022]
Abstract
Our aim was to evaluate the long-term skeletal stability of the mandible in 21 patients after orthognathic surgery with physiological positioning. The measurement points SNB, B point (X, Y), Pog (X, Y), and the angle of the ramus were measured on cephalometric photographs to assess skeletal stability preoperatively, immediately after operation, and one and two years postoperatively. In addition, we evaluated the clinical symptoms of disorders of the temporomandibular joint (TMJ). The analysis of the cephalometric photographs showed that SNB, B point X, and Pog X showed no significant differences among the postoperative time points. On the other hand, B point Y and Pog Y showed no significant differences throughout the study period. We compared the angle of the ramus before operation and two years postoperatively, and no significant difference was found. In addition, no cases showed any pathological symptoms of disorders of the TMJ two years postoperatively. The long-term stability after orthognathic surgery with physiological positioning was confirmed, and it seems to be a reliable orthognathic treatment in patients with mandibular prognathism.
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Jung J, Kim JH, Lee JW, Ohe JY, Choi BJ. Three-dimensional volumetric analysis of condylar head and glenoid cavity after mandibular advancement. J Craniomaxillofac Surg 2018; 46:1470-1475. [PMID: 30196856 DOI: 10.1016/j.jcms.2018.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess condylar resorption, spatial change in glenoid cavity, and its risk factors after mandibular advancement by three-dimensional volumetric analysis. Subjects consisted of 30 condyles of 15 patients diagnosed with mandibular retrognathism who underwent Le Fort I and bilateral sagittal split ramus osteotomy advancement. CBCT images were taken before surgery (T0), immediately after surgery (T1), and postoperatively at 6 months (T2) and 1 year (T3). Condylar resorption was observed in 21 condyles. The posterior was the most affected region, while the anterior was the least affected. The volume of the glenoid cavity was significantly increased after surgery regardless of the presence or absence of resorption. However, the cavity recovered close to its original volume over time. At 1 year after surgery, the volume was not significantly different from the preoperative volume. Counterclockwise rotation of the proximal segment was found to be a risk factor affecting resorption based on correlation analysis. Mandibular advancement appeared to generate excessive mechanical stress on the posterior condyle, and might be responsible for the resorption. Counterclockwise rotation might have added stress to the region. Articular spatial change was transient and did not appear to be related to condyle resorption.
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Affiliation(s)
- Junho Jung
- Department of Oral and Maxillofacial Surgery (Head: Prof. Byung-Joon Choi), School of Dentistry, Kyung Hee University, 02447, Seoul, Republic of Korea
| | - Jung-Ho Kim
- Department of Oral and Maxillofacial Surgery (Head: Prof. Byung-Joon Choi), School of Dentistry, Kyung Hee University, 02447, Seoul, Republic of Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery (Head: Prof. Byung-Joon Choi), School of Dentistry, Kyung Hee University, 02447, Seoul, Republic of Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery (Head: Prof. Byung-Joon Choi), School of Dentistry, Kyung Hee University, 02447, Seoul, Republic of Korea
| | - Byung-Joon Choi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Byung-Joon Choi), School of Dentistry, Kyung Hee University, 02447, Seoul, Republic of Korea.
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Choi BJ, Lee BS, Kwon YD, Lee JW, Yun SU, Ryu KS, Ohe JY. Correlation between intraoperative proximal segment rotation and post-sagittal split ramus osteotomy relapse: a three-dimensional cone beam computed tomography study. Int J Oral Maxillofac Surg 2017; 47:613-621. [PMID: 29146395 DOI: 10.1016/j.ijom.2017.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/07/2017] [Accepted: 10/25/2017] [Indexed: 10/18/2022]
Abstract
This study evaluated the effects of proximal segment rotation and the extent of mandibular setback on post-sagittal split ramus osteotomy (SSRO) relapse using three-dimensional (3D) analysis. Thirty-one patients diagnosed with a skeletal class III malocclusion who underwent SSRO alone were enrolled in this study. The movements of the mandibular condyles were assessed using cone beam computed tomography (CBCT) and a 3D imaging program at ≤1 month before the operation (T0), 1 week after the operation (T1), and 6 months (T2) and 1year (T3) postoperative. Yaw and roll were increased at T1 as compared to T0. However, the proximal segments reverted to their original positions between T2 and T3. There was a positive correlation between the extent of the posterior movement of the mandible and relapse at 6 months and 1year postoperative. Although the proximal bone segments showed displacement in three dimensions at T1, they reverted to their original positions over time. In addition, although there was a positive correlation between the extent of the posterior movement of the mandible and the occurrence of post-surgical relapse at 6 months and 1year post-surgery, the rotation of the proximal bone segment during surgery had no relationship with postoperative relapse.
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Affiliation(s)
- B-J Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - B-S Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Y-D Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - J-W Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - S-U Yun
- Yuseong Sun Hospital, Daejeon, South Korea
| | - K-S Ryu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - J-Y Ohe
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea.
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Choi BJ, Choi YH, Lee BS, Kwon YD, Choo YJ, Ohe JY. A CBCT study on positional change in mandibular condyle according to metallic anchorage methods in skeletal class III patients after orthognatic surgery. J Craniomaxillofac Surg 2014; 42:1617-22. [PMID: 24962042 DOI: 10.1016/j.jcms.2014.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/21/2014] [Accepted: 05/06/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was to evaluate the postoperative stability of the mandibular condyle according to the number of screws in the proximal segment using cone beam computed tomography (CBCT). PATIENTS AND METHODS Thirty patients diagnosed with skeletal class III malocclusion and underwent sagittal split ramus osteotomy (SSRO) were enrolled in this study. In Group A, 4 screws and a 4-hole miniplate were used for the internal fixation of an osteotomy and 3 screws, only 1 screw in the proximal segment, and a 4-hole miniplate were used in Group B. We digitally measured anteroposterior, supero-inferior, and mediolateral positions and angles of the long axis of the mediolateral poles in CBCT scans pre-operatively, within 1 week postoperatively and 3, 6 months after surgery. RESULTS The condylar head angle in the axial plane showed consistent and significant changes. The condylar head angle in the coronal plane decreased in both groups, which shows that condylar heads bent inward. In the axial plane, Group A showed statistically significant differences while Group B did not in early stage (T0-T1-T2). The change in distance between condylar heads shows that these have moved outward in both groups. CONCLUSION The results show that a fixation method using 3 screws with a 4-hole miniplate did seemed preferable and may give some flexibility for condylar heads to be positioned in physiologic position during postoperative phase.
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Affiliation(s)
- Byung-Joon Choi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea
| | - Yong-Ha Choi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea
| | - Yong-Jin Choo
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung-Hee University, Seoul 130-702, Republic of Korea.
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Rai KK, Arakeri G, Khaji SI. A Bony Landmark 'RAI Triangle' to Prevent 'Misplaced and Misdirected' Medial Cut in SSRO. J Maxillofac Oral Surg 2011; 10:90-2. [PMID: 22379330 DOI: 10.1007/s12663-010-0042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 04/26/2010] [Indexed: 10/18/2022] Open
Abstract
'Rai triangle', a new anatomic landmark on the medial surface of the ramus of the mandible which when identified and taken into consideration, may have a definite advantage. This is especially in terms of performing the medial horizontal cut which is an important and integral part of the sagittal split ramus osteotomy so as to avoid a bad split. The objective of this article is to propose an easily identifiable bony land mark, which is closely related to lingula of mandible that may ease the procedure of osteotomy and avoid bad splits.
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